CAROLYN C GIBSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****83

License Status

NOT RENEWED

Business

Title

First Name

CAROLYN

Middle

Last Name

GIBSON

Business Name

CAROLYN C GIBSON OD

Original Issue Date

09/24/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006